Diabetes Mellitus Flashcards Preview

MCBM Exam 4 Kat > Diabetes Mellitus > Flashcards

Flashcards in Diabetes Mellitus Deck (43):
1

What is Type 1 Diabetes?

An autoimune destruction of pancreatic beta cells resulting in a lack of insulin production

2

What is Type 2 Diabetes

Insulin resistance due to insulin signaling defect

3

What percent of women develop gestational diabetes?

4% or about 135,000 cases/yr

4

About how many americans have diabetes?

25.8 million (8.3%)

5

What percent of diabetics are Type 1?

5-10%

6

Define Polyuria and what causes it in diabetes.

Excess glucose, urea and ketone bodies are excreted and water goes with them

7

Define Polydypsia and what symptom of diabetes causes it.

Dehydration leads to excessive thirst

8

What dental issues come with polydypsia?

Xerostomia
Dental Caries

9

Define Polyphagia and what symptom of diabetes causes it?

Lack of insulin action on anorexigenic peptide synthesis leads to excessive hunger

10

What are the acute symptoms of uncontrolled diabetes?

Polyuria
Polydypsia
Polyphagia

11

What is Diabetic Ketoacidosis (DKA) caused by?

Insufficient insulin leading to persistent high blood glucose (>300mg%)

12

What is DKA often associated with?

Infection - 40%
Missed insulin - 25%
Untreated or undiagnosed - 15%

13

What are other stresses that may be associated with DKA?

Heart attack
Stroke
Trauma
Surgery

14

What are some symptoms of DKA?

Acetone Breath
Kussmaul breathing (short breath and increased respiration)
Excessively high blood glucose

15

What are the 4 main diagnostic tests for diabetes?

Fasting Plasma Glucose Test (FPG)
Oral Glucose Tolerance (OGTT)
Hemoglobin A1c
C-peptide

16

What is the pre-diabetic and diagnostic levels of FPG?

100-125 mg% in pre diabetics
>126 mg% is diagnostic

17

What is the pre-diabetic and diagnostic levels of OGTT?

140-199 mg% @ 2 hr is pre-diabetes
>200 mg% is diagnostic

18

What is the management goal of Hemoglobin A1c?

<7%

19

What does the C-peptide diagnostic test do?

Verifies Type 1

20

In the glucose tolerance test are [blood glucose] levels elevated or depressed?

Elevated when compared to normal

21

When HbA1c levels go up what happens to the blood glucose levels?

It increases at a proportional rate

22

What is a byproduct of converting proinsulin to mature insulin?

The C peptide

23

What is the treatment goal of diabetes?

Lower blood glucose level

24

What is the direct target of weight loss and what is its overall effect?

The direct target is adipose tissue with an overall effect of restoring insulin sensitivity

25

What is the direct target of exercise and what is its overall effect?

The direct target is Muscle and AMPK Activation with an overall effect of enhancing glucose uptake

26

What is the direct target of sulfonylureas and what is its overall effect?

The direct target is K+ channel blocker with an overall effect of enhancing insulin secretion

27

What is the direct target of Biguanides and what is its overall effect?

The direct target is AMPK activator with an overall effect of enhancing glucose uptake

28

What is the direct target of Thiazoladinediones and what is its overall effect?

The direct target is PPARgamma activator with an overall effect of potentiating insulin

29

What is the direct target of insulin and what is its overall effect?

The direct targets are muscle and adipose with an overall effect of enhancing glucose uptake

30

Long term sequelae of diabetes?

Diabetic Retinopathy
Periodontal Disease
CVD and Stroke
End Stage Renal Disease
Peripheral Neuropathy
Prolonged wound healing
Infection

31

What is glycation?

Stable, covalent ketoamine linkage of glucose to amino termini and lysine residues of proteins

32

What results in glycation?

Glucose spontaneously participating in a Schiff reaction

33

What are the end products of glycation called?

AGEs or Advanced Glycation End Products

34

What are receptors of AGEs called?

RAGEs

35

What do RAGEs trigger?

Increased oxidative stress
Mimics chronic inflammation via NFkB

36

What are some sequelae of Chronic Vascular Inflammation?

Increased risk for development of atherosclerotic plaques
Impaired vasodilation
Impaired flow-mediated dilation
Impaired response to adenosine
Increased stiffness of aorta
Renal & Carotid artery stenosis

37

How does one diagnose Periodontitis?

Appearance of gingival
Bleeding on probing
Pocket probign depth
Tooth Mobility
Alveolar bone loss

38

What might perio disease contribute to?

Insulin resistance

39

At what percent is HbA1c considered to increased the risk of severe periodontal disease by 3?

9%

40

What does excess insulin lead to?

Hypoglycemia

41

What are the symptoms of hypoglycemia?

Confusion
Irritability
Sweating
Shakiness
Unconsciousness

42

What should you do if blood glucose is <70 mg%?

Use the rule of 15

43

What is the rule of 15?

15g carbs increases blood glucose by 15mg% in 15mins